Household Contamination of Baby Bottles and Opportunities to Improve Bottle Hygiene in Peri-Urban Lima, Peru

Mendoza, Alejandra Llican; Winch, Peter J.; Calderón Sánchez, Maritza Mercedes; Gilman, Robert Hugh; Pachas, Jessica; Cabrera, Lilia Z.; Pajuelo Travezaño, Monica Jhenny; Rothstein, Jessica D.; Caulfield, Laura E.

dc.contributor.author	Rothstein, Jessica D.
dc.contributor.author	Mendoza, Alejandra Llican
dc.contributor.author	Cabrera, Lilia Z.
dc.contributor.author	Pachas, Jessica
dc.contributor.author	Calderón Sánchez, Maritza Mercedes
dc.contributor.author	Pajuelo Travezaño, Monica Jhenny
dc.contributor.author	Caulfield, Laura E.
dc.contributor.author	Winch, Peter J.
dc.contributor.author	Gilman, Robert Hugh
dc.date.accessioned	2019-07-04T17:00:16Z
dc.date.available	2019-07-04T17:00:16Z
dc.date.issued	2019
dc.identifier.uri	https://hdl.handle.net/20.500.12866/6823
dc.description.abstract	Feeding of infant formula using contaminated bottles may be an important transmission pathway of enteric pathogens during early life. Determinants of suboptimal bottle hygiene and the feasibility and acceptability of intervention strategies have not been well assessed. We evaluated the extent of bottle contamination, its contributing factors, and options for promoting improved bottle hygiene in a Peruvian shantytown. During Phase 1, we sampled from bottles and caregiver hands (n = 48) and processed for enumeration of total coliform and Escherichia coli colony-forming units. A semi-structured questionnaire captured bottle use and hygiene practices. Phase 2 involved the identification of candidate practices to recommend to caregivers. Phase 3 consisted of a behavioral trial in which 14 caregivers were educated about improved practices for bottle disinfection and later reported on their experiences implementing them. Fecal bacteria were detected in 43.8% of bottles sampled during Phase 1 and in 21.7% of hands. Caregivers overall did not use effective methods for disinfecting bottles, displayed misunderstandings surrounding hygienic practices, and few had ever discussed bottle hygiene with a health provider. Findings from the behavioral trial indicated that the improved practice of brushing the bottle with dish detergent for 30 seconds after every use is preferable to boiling the bottle for several minutes daily as caregivers reported that the brush was simple to use, efficient, and practical. The promotion of a bottle brush and detergent is a feasible and acceptable intervention strategy in peri-urban settings, and future research should evaluate its long-term effectiveness for reducing bottle contamination.	en_US
dc.language.iso	eng
dc.publisher	American Society of Tropical Medicine and Hygiene
dc.relation.ispartofseries	American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Article	en_US
dc.subject	bacterial count	en_US
dc.subject	bacterium contamination	en_US
dc.subject	bacterium detection	en_US
dc.subject	bottle hygiene	en_US
dc.subject	caregiver	en_US
dc.subject	cleaning	en_US
dc.subject	cohort analysis	en_US
dc.subject	coliform bacterium	en_US
dc.subject	colony forming unit	en_US
dc.subject	controlled study	en_US
dc.subject	detergent	en_US
dc.subject	disinfection	en_US
dc.subject	Escherichia coli	en_US
dc.subject	feasibility study	en_US
dc.subject	feces microflora	en_US
dc.subject	female	en_US
dc.subject	household	en_US
dc.subject	human	en_US
dc.subject	hygiene	en_US
dc.subject	infant	en_US
dc.subject	male	en_US
dc.subject	nonhuman	en_US
dc.subject	Peru	en_US
dc.subject	Peruvian	en_US
dc.subject	risk assessment	en_US
dc.subject	risk reduction	en_US
dc.subject	structured questionnaire	en_US
dc.subject	urban area	en_US
dc.title	Household Contamination of Baby Bottles and Opportunities to Improve Bottle Hygiene in Peri-Urban Lima, Peru	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.4269/ajtmh.18-0301
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn	1476-1645